Mobility, Transfers, Falls, Body Mechanics, and Emergencies
Key Takeaways
- Safe mobility begins with the care plan, footwear, locked wheels, clear pathways, gait belt use when indicated, and the correct number of helpers.
- Good body mechanics keep the CNA's base wide, back aligned, load close, knees bent, and movement powered by the legs rather than twisting the back.
- A resident who falls should not be moved until the nurse assesses the resident unless there is immediate danger.
- Emergency responses prioritize calling for help, protecting the resident from further harm, and following facility procedures such as RACE for fire and appropriate choking response.
- Kansas CNA questions often use unsafe shortcuts as distractors, including transferring alone against the care plan, pulling on weak arms, ignoring dizziness, or leaving a resident after a fall.
Mobility starts with the care plan
Before transferring or ambulating a resident, check the care plan and current condition. A Kansas CNA should know whether the resident is independent, standby assist, one-person assist, two-person assist, mechanical lift, or non-weight-bearing. Do not downgrade the help required because the unit is busy. If the care plan says two-person assist, the CNA waits for the second helper. If the resident seems weaker, dizzy, confused, short of breath, or in new pain, stop and report before moving.
Prepare the environment. Lock bed and wheelchair brakes, move footrests, place the bed at a safe height, clear clutter, check footwear, make sure the destination is ready, and keep the call light available. Use a gait belt when indicated and place it snugly over clothing, not on bare skin, not over breasts, tubes, wounds, or a recent surgical site. Explain the move and count before standing.
| Task | Safety check |
|---|---|
| Bed to wheelchair | Lock wheels and position chair close |
| Ambulation | Use gait belt and non-skid shoes if indicated |
| Mechanical lift | Use trained helpers and the correct sling |
| Weak side | Support according to care plan, do not pull the arm |
| Dizziness | Sit or lie resident safely and report |
Body mechanics protect everyone
Body mechanics means using the body in a way that reduces strain. Keep feet shoulder-width apart, bend knees, tighten core muscles, keep the load close, and face the direction of movement. Push, pull, or slide when appropriate instead of lifting. Avoid twisting while carrying weight. Raise the bed to working height for care when allowed, then lower it before leaving.
A CNA should ask for help or use a mechanical device when the task is too heavy or unsafe. Pride is not a safety plan. Injuring the CNA can also injure the resident if the resident falls during a poorly controlled move.
Falls and near falls
If a resident begins to fall, do not try to hold the resident upright by force. Widen your stance, support the resident close to your body if possible, and ease the resident to the floor while protecting the head. Call for help. After a fall, keep the resident still and stay with the resident. Do not move the resident, return them to bed, or offer food or fluids until the nurse assesses the situation, unless there is an immediate danger such as fire.
Report exactly what happened and what you observed: location, position found, resident statements, pain, bleeding, visible injury, mental status, and whether the fall was witnessed. Document according to policy after the resident is safe and the nurse has been notified.
Emergencies: first safe action
Emergency questions reward sequence. For fire, remember RACE: rescue residents in immediate danger, activate the alarm, contain the fire by closing doors, and extinguish or evacuate if trained and directed. For extinguisher use, PASS means pull, aim, squeeze, sweep. The CNA should follow the facility plan and never use elevators during a fire unless the plan specifically directs.
For choking, if the adult resident cannot speak, cough, or breathe, call for help and begin the facility-approved abdominal-thrust response if trained. If the resident can cough forcefully, encourage coughing and stay with the resident. For a seizure, protect from injury, lower to the floor if needed, move objects away, do not restrain, do not put anything in the mouth, time the seizure if possible, and report. For an unresponsive resident, call for help, check responsiveness and breathing according to training, and follow facility emergency procedure.
Exam traps
Reject answers that transfer against the care plan, leave a resident unattended on a toilet, pull on a paralyzed arm, unlock brakes after standing, move a fallen resident without nurse assessment, restrain a seizing resident, or investigate a gas smell alone. Safe CNAs stop unsafe care early, call for help, and report changes promptly.
A resident's care plan says two-person assist for transfers, but the second CNA is busy. What should the CNA do?
A resident is found on the floor after an unwitnessed fall. What should the CNA do first?
During a meal, an adult resident suddenly cannot speak, cough, or breathe and clutches the throat. What should the CNA do?